Auto Pay Credit Card Authorization Form 3% Service Fee Name as it appears on card:Credit Card Number:Mailing Address (with zip code):Expiry Date: MM slash DD slash YYYY For security purposes, please text, email, or call Adam for CCV, number on the back of the card.By signing below, you are giving authorization for AZ Cool Pools LLC to charge your card for monthly services and repairs. You will receive an invoice statement at the end of each service month prior to card being charged, however no action is required on your part. Our accounting software allows you the opportunity to click on and review each invoice, or review past invoices at any time.Print Cardholder NameCardholder SignatureDate MM slash DD slash YYYY OFFICE USE ONLYDate Received: MM slash DD slash YYYY Account Number:Date of First Charge: MM slash DD slash YYYY Comm:
